Healthcare Provider Details

I. General information

NPI: 1184778318
Provider Name (Legal Business Name): PARLAND PLACE COMMUNITY LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 PARLAND PL
SAN ANTONIO TX
78209-6529
US

IV. Provider business mailing address

123 PARLAND PL
SAN ANTONIO TX
78209-6529
US

V. Phone/Fax

Practice location:
  • Phone: 210-828-1460
  • Fax: 210-828-3784
Mailing address:
  • Phone: 210-828-1460
  • Fax: 210-828-3784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number010286
License Number StateTX

VIII. Authorized Official

Name: MS. FRANCES M. KEITH
Title or Position: ADMINISTRATOR
Credential:
Phone: 210-828-1460